Recognition and Treatment of Obsessive-Compulsive Disorder
J Clin Psychiatry 2007;68(12):e30
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Obsessive-compulsive disorder (OCD) is prevalent, chronic, and potentially
disabling. It is characterized by recurrent, unwanted, and distressing thoughts
(obsessions) and repetitive, irresistible, behaviors (compulsions). Individuals
with OCD recognize that the obsessions and compulsions are senseless or
excessive yet they are unable to stop these behaviors. Some etiologic theories
of OCD suggest a biological origin, including hypotheses involving the
serotonergic system, the glutamatergic system, the orbital cortex and the basal
ganglia, and streptococcal throat infections in children. Standard treatments
for OCD include selective serotonin reuptake inhibitors (SSRIs) and
cognitive-behavior therapy. Combining SSRIs with other medications has
relatively little empirical support; however, the adjunctive use of
antipsychotics has been shown to be effective. Neurosurgery, such as deep brain
stimulation, has also been shown to be effective in select patients with
debilitating and refractory OCD.
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